By Toye Olori
LAGOS, Sep 11 1998 (IPS)

Nigeria’s war against guinea worm has almost been won, but the remnants of the water-borne disease — estimated to be two percent — are still resisting.

Since its inception 10 years ago, the Nigeria Guinea Worm Eradication Programme (NIGEP), has eliminated 98 percent of the epidemic. Eka Braide, NIGEP’s South East Zone director, said they expect to eradicate the disease by the year 2000.

“Ten years of eradication is long and tiring, so let us put everything into it, as other diseases are calling for attention,” she told a NIGEP meeting in the eastern city of Enugu recently.

As part of efforts to achieve 100-percent eradication by the year 2000, set by the World Health Organisation (WHO), NIGEP has started a village-to-village search project.

NIGEP teams have covered Benue, Enugu and Ebonyin states, all in the South East zone, where filters, water treatment chemicals and health education pamphlets were distributed to villagers as part of the programme to combat the scourge.

“The village-to-village case search shows that villagers still believe guinea worm is from God and it is only God that can take it from their village,” said Inyang Oko.

Oko, who is the director of the Enugu State Public Health Services, said many villages in the endemic areas still lack portable water, so it is easy for the disease to spread through the use of stream or pond waters.

NIGEP conducted annual case searches in 1988, 1989 and 1990 in the country’s four guinea worm zones, after which, emphasis was shifted to monthly surveillance and reporting, and from case reduction to case containment.

A NIGEP report, made available to IPS this week, shows that although cases in the country have been reduced from 653,520 in 1988 to 12,282 by the end of last year, the country still ranks second among the 18 endemic countries globally, with Sudan topping the list.

The village-to-village search in the South East zone, is sponsored by the WHO and the US-based Global 2000, which is involved in the global eradication of guinea worm.

“The search will enable the programme to determine the actual status of guinea worm in all the villages visited, so as to prepare us for the next transmission season which will begin soon,” Braide said.

Transmission season in Nigeria varies from area to area. But in the South East zone, the season starts in October and ends in March. The zone made up of 10 states, five of which are still regarded as endemic areas, has opened a centre to monitor and supervise activities in each village.

According to Braide, the zone has achieved a 98.16 percent case reduction from 278,635 in 1988, when intervention began, to 5,128 cases at the end of 1997.

There was also a corresponding reduction in the number of endemic villages from 1,374 villages in 1988 to 799 villages last year, she said.

Braide said the UN Children’s Fund (Unicef), which has been at the forefront in the provision of water to villages through its Water and Sanitation Programme, would have eliminated the scourge, had the donors not withdrawn their funding in protest against the late Gen. Sani Abacha’s excesses.

The guinea worm — a threadlike creature measuring 60-120 cm long — lives in the connective tissues beneath the skin. It releases its larvae into a large blister on the legs or arms. The diesease is contracted by drinking contaminated water.

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